Safe supply and safe injection sites

Recently a National Post article did a 11,000 word essay on why safe supply is not working. Conservatives have jumped on this while Liberals and other progressives have slammed them as not following evidence and science. I would generally say I lean against both safe supply and safe injection sites but I am open to them in some cases as well as open to being convinced otherwise.

National Post for safe supply shows many who get it are not getting the high they want and are instead diverting it and selling it to teenagers to get fentanyl while getting more hooked on opioids. Also points out many doctors sounding alarm are afraid to due to pressure from other colleagues. There is no question in academia, activist and those on left have a lot of sway thus while I generally trust experts, as per my previous post I do also question them when I have good reason to but not on ignorance. I think with physical sciences, saying listen to experts is easy as can be deduced in exact mathematics and results same every time. With social sciences it is a different story as humans are complex beings and behaviour cannot be deduced to mathematical models the way it can for physical sciences. Another problem I find with many experts is they insert their own values rather than realize with everything there are trade offs and different people may have different views on what are reasonable trade offs. For example on a parallel private health care system, most experts are against it since they put equity as top priority even if it means lower quality but ignore some may be willing to sacrifice for a little less equity if higher quality. Same thing with pandemic as many putting to stopping spread as top priority and ignored things like decline in mental health and financial health which matter too. I get impression here most experts putting saving lives at least short term as top priority while increased crime or making communities less livable secondary. Never mind anyone who does drugs will eventually die of it as hard on heart. Safe supply may keep person alive long enough they can get treatment, but that assumes they will get treatment.

My view is we should show compassion for addicts and help them get clean but we need to use both a carrot and stick approach. That is why I favour Portuguese model where it is a choice of treatment and no criminal record or go to jail (this is not forced treatment as possession is still a criminal offence in Canada). When one is addicted, if you just try to meet them where at, many will never seek treatment. There needs to be some pressure for them to get clean. Likewise I prefer methadone treatment where yes they are prescribed opioids to avoid harmful withdrawal but it is taken under direct supervision of a doctor not on own and the amount is gradually reduced with the goal of getting the person off the drugs while avoiding withdrawal symptoms. Current approach is just give safe supply which is not really safe and let them take where they want and no incentive to get off it. For comparison safe supply is like a bottle of vodka with alcohol while fentanyl more like moonshine. Latter can kill you on one dose while former won’t kill you right away, but if use for entire life, likely die in 50s or 60s as it is still hard on the heart which will eventually go. Thus that is why I support a program of gradual reduction. That being said I am open to being convinced otherwise as I realize this is a tough issue with no easy solution. But if safe supply advocates are so convinced it works, they should do following: find two communities that are very similar and have safe supply in one and not other and compare real world results. If community with it fairs better, then expand nationwide while if fairs worse, drop idea and try something else. Even Health Canada’s website claims results inconclusive so like any idea you test it in real world. You don’t just go on hypothesis and say this works, that is not how science works. Some will say you cannot force addicts but like all rights you have to look at impacts on others. If only impacting themselves I would agree, but reality is drug users harm others not just user thus why I oppose legalization of hard drugs. Yes I know we allow alcohol which is not harmless by any means but alcohol while more harmful than marijuana is not as harmful as cocaine or heroin. Some studies show it causes most damage to society, but that is only because number of who use it is astronomically higher. If you do it based on how many use it, it is not as harmful. Consumption of alcohol in many Muslim countries is similar to percentage who use illicit drugs in North America and harm from alcohol negligible there.

Safe injection sites are a different issue, but I have long been skeptical of them. I understand they save lives which is a good thing, but reality is wherever put they will be a magnet for drug dealers making those communities less safe and driving away businesses as well as causing property values to fall. So I believe they should be limited to only the very worse areas, not as widespread as they are now. In Downtown Eastside, it hasn’t made things worse as things really bad there already. But in both Calgary and Lethbridge, it did make things worse as those were communities with some drug use but also vibrant and safe ones. I wouldn’t close any immediately, but I would like to see a moratorium on new sites and if an area without one has an upsurge use mobile vans instead of a permanent fixed address to temporarily deal with it. But over the next decade, I would like to see efforts to phase them out by real effort not just on keeping addicts alive, but getting them off drugs and once drug addiction drops enough that they are no longer warranted, then close them. These are at best at stop gap solution, not a long term one. Likewise for jurisdictions around the world thinking of opening them, I would say be very careful. In US where they are not legal although one exists in New York City, I support states like what Pennsylvania is doing with bipartisan support in passing bans on them. In UK where I visit frequently and also has none, I would prefer it stays that way or at least limit any to Glasgow only (it is by far the worst community in UK) and not open them in other cities.

2 thoughts on “Safe supply and safe injection sites

  1. Miles, I am afraid I have to differ with your analysis on the most promising path to a safer society for everyone when it comes to dealing with the complex, inter-sectional nature of mental health, addiction and homelessness. But I am going to let the most knowledgeable folks I know on these matters (Rory & Anton) debate it with you in person when you get together. No doubt the conversation will be lively, and hopefully you will all feel heard if not agreed with (:


    1. You may want to watch Canada is dying and also check National Post article on this that is 11,000 words. Yes both are right wing but does interview some who are not and claim problems. I don’t think safe supply if done right is problematic. Problem is even safe supply is not safe, just less deadly than fentanyl but still drugs that are addictive and if taken for life, probably die young from a heart attack. So it should be a program that supplies them to avoid withdrawal symptoms but with goal of moving them off.


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